Organization
GUS S. RUSSO DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GUS S RUSSO DDS (PRESIDENT/OWNER)
(215) 757-0864
Entity
Organization
Contact information
Practice address
310 MIDDLETOWN BLVD, THE COURTYARD AT OXFORD VALLEY STE 202, LANGHORNE, PA 19047-3203
(215) 757-0864
(215) 757-8090
Mailing address
310 MIDDLETOWN BLVD, THE COURTYARD AT OXFORD VALLEY STE 202, LANGHORNE, PA 19047-3203
(215) 757-0864
(215) 757-8090
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DSO19052L
PA
Other
Enumeration date
07/30/2007
Last updated
07/30/2007
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